Main Street Counseling, LLC
Organization Active NPI Professional Counselor · Allentown, NJ
NPI 1043610140 · NPPES record last updated Nov 16, 2021
Key facts
- NPI
- 1043610140
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Professional Counselor 101YP2500X
- License
- 37PC00415100 (NJ)
- Legal business name
- MAIN STREET COUNSELING, LLC
- Practice address
- 16 Ichabod LN
Allentown, NJ 08501-1959 - Phone
- (609) 208-3053
- NPI assigned
- Aug 26, 2014
- Organization subpart
- No
Authorized official
- Name
- Mr. Justin Adam Kahn, LPC
- Title
- Licensed Professional Counselor
- Phone
- (609) 208-3053
Practitioners 15
-
Susan J. Conley, LPC, LCADC
-
Miriam Rebekah Egan, LAC, NCC
-
Patricia Ann Lieberman, MASTERS
-
Alison Margaret Locklear, MSW, LCSW
-
Adelyn Myers, MA, LPC
-
Hannah Wheat, BSW
-
Lori Amison, LPC
-
Dale Beth Bromberg, MSW, LCSW
-
Christine A Davirro, LPC
-
Justin Adam Kahn, LPC
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NJ
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20211124002278 | NJ | Part B Supplier - Clinic/Group Practice | 7113317694 |
Receives reassigned benefits from 13 practitioners Practice locations: Hamilton, NJ |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor |
101YP2500X | 37PC00415100 | NJ | Yes |
Addresses
Primary practice location
16 Ichabod LN
Allentown, NJ 08501-1959
Mailing address
16 Ichabod LN
Allentown, NJ 08501-1959
Phone (609) 208-3053
Other providers in Allentown, NJ
- Tonimaria Lee
- Tracy Ann Lezott
- Stephanie Huth Lipnicki
- Amy Lipput
- Kate Elizabeth Lodolce
- Meghan McGovern
- Peter Andrew Meerwarth
- Erica Newborn
- Cynthia C Ninivaggi
- North Star Therapeutic Counseling Services LLC
All providers in Allentown, NJ · Professional Counselor in New Jersey
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 16, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.